White Blood Cell Count to Mean Platelet Volume Ratio as a Novel Non-Invasive Marker Predicting Short-term Outcomes in Patients with Non-ST Elevation Myocardial Infarction

Author : Y. Saragih, B. Napitupulu, A.N. Nasution, A.H. Raynaldo, H. Hasan
Upload Date : 19-04-2018

Background: Recent studies have shown that complete blood count (CBC) parameters can effectively predict long-term mortality and re-infarction rates in acute coronary syndrome (ACS). However, the role of these parameters in predicting short-term outcomes has not been studied extensively. The main objective of this study was to determine whether CBC parameters can predict the incidence of major adverse cardiac event (MACE) in ACS patients especially in NSTEMI.

Methodology: A total of 212 patients with NSTEMI were recruited in this retrospective study. The relationship of baseline white blood cell (WBC) to mean platelet volume ratio (WMR) with MACE was assessed in hospital. The patients were divided into two groups: Group A [MACE-positive] and Group B [MACE-negative]. Multivariate COX regression was performed to calculate hazard ratios (HR).

Results: WMR had the highest area under receiver operating characteristics curve and highest discriminative ability amongst all CBC parameters in predicting MACE. Dibetes Mellitus (p = 0.016), WBC count (p < 0.001), MPV (p = 0.008), WMR (p < 0.001), neutrophil (p < 0.001), Ureum (p < 0.001), Creatinine (p < 0.001), CKMB (p = 0.007), GRACE score (p < 0.001), and CRUSADE score (p < 0.001) were significantly higher in the MACE-positive group as compared to MACE-negative. MACE-positive group had lower GFR (p = 0.002) and Ejection Fraction (p < 0.001) than MACE-negative group. In Multivariate Cox regression analysis, WMR > 1000 (HR = 1.1, 95% CI, p = 0.01) was found to be strongest biochemical marker in predicting mortality.

Conclusion: WMR is an easily accessible and an inexpensive indicator which may be used as a prognostic marker in patients with NSTEMI.


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